Skip to main content
Log in

The Relationship Between Cognitive Function, Depressive Behaviour and Sleep Quality with 24-h Urinary Sodium Excretion in Patients with Essential Hypertension

  • Original Research Article
  • Published:
High Blood Pressure & Cardiovascular Prevention Aims and scope Submit manuscript

Abstract

Background

Various studies have shown that sodium intake is related to increased blood pressure. However, the relationship between sodium intake and cognitive function and depression has not previously been studied.

Aim

The objective of this study was to investigate the relationship between 24-h sodium excretion with cognitive function, depression and sleep quality in patients newly diagnosed with essential hypertension.

Methods

All patients underwent history taking, physical examination, blood pressure measurement, 12-lead ECG evaluation, routine urine analysis, biochemical analysis and 24-h urine collection to measure urinary sodium and protein excretion and creatinine clearance, evaluation of cognitive function, depressive behaviour and sleep quality.

Results

In total, 119 patients newly diagnosed with essential hypertension (50 men and 69 women aged 54.2 ± 16.1 years) were enrolled. The 24-h urinary sodium excretion of the patients was 204.0 ± 240.4 mEq/day. The Standardized Mini Mental State Examination (SMMSE), Pittsburgh Sleep Quality Index and Beck Depression Inventory scores of the patients were 26.0 ± 2.7, 5.6 ± 3.1 and 21.6 ± 13.5, respectively. Spearman correlation analysis revealed that 24-h urinary sodium excretion was correlated with age (rho −0.258, p = 0.005), systolic blood pressure (rho 0.219, p = 0.017), diastolic blood pressure (rho 0.195, p = 0.034), creatinine clearance (rho 0.414, p < 0.0001) and SMMSE score (rho −0.257, p = 0.005). Stepwise linear regression of independent factors revealed that gender (p < 0.0001), creatinine clearance (p < 0.0001), systolic blood pressure (p = 0.031) and SMMSE score (p < 0.0001) were independently related to logarithmically converted 24-h sodium excretion.

Conclusion

The current study demonstrated that better cognitive function, but not depressive behaviour and sleep disturbance, is related to decreased sodium intake as evaluated by 24-h urinary sodium excretion. Studies are needed to highlight the mechanisms regarding the relationship between cognitive function and sodium intake.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Arici M, Turgan C, Altun B, Sindel S, Erbay B, Derici U, Karatan O, Erdem Y, Hasanoglu E, Caglar S, Turkish Society of Hypertension and Renal Diseases. Hypertension incidence in Turkey (HinT): a population-based study. J Hypertens. 2010;28:240–4.

    Article  PubMed  CAS  Google Scholar 

  2. INTERSALT Cooperative Research Group. INTERSALT: an international study of electrolyte excretion and blood pressure—results for 24 hour urinary sodium and potassium excretion. BMJ. 1988;297:319–28.

    Article  Google Scholar 

  3. Erdem Y, Arici M, Altun B, Turgan C, Sindel S, Erbay B, Derici U, Karatan O, Hasanoglu E, Caglar S. The relationship between hypertension and salt intake in Turkish population: SALTURK study. Blood Press. 2010;19:313–8.

    Article  PubMed  CAS  Google Scholar 

  4. Chobanaian AV, Bakris GL, Black HR, Cushman WC. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560.

    Article  Google Scholar 

  5. Mancia G, De Backer G, Dominiczak A, et al. Management of Arterial Hypertension of the European Society of Hypertension; European Society of Cardiology. 2007 Guidelines for the Management of Arterial Hypertension. The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007;25:1105–87.

    Article  PubMed  CAS  Google Scholar 

  6. Roberts WC. High salt intake, its origins, its economic impact, and its effect on blood pressure. Am J Cardiol. 2001;88:1338–46.

    Article  PubMed  CAS  Google Scholar 

  7. Luft FC, Morris CD, Weinberger MH. Compliance to a low-salt diet. Am J Clin Nutr. 1997;65(2 Suppl.):698S–703S.

    PubMed  CAS  Google Scholar 

  8. Junge W, Wilke B, Halabi A, Klein G. Determination of reference intervals for serum creatinine, creatinine excretion and creatinine clearance with an enzymatic and a modified Jaffe method. Clin Chim Acta. 2004;344:137–48.

    Article  PubMed  CAS  Google Scholar 

  9. Chobanian AV, Bakris GL, Black HR, Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee, et al. Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42:1206–52.

    Article  PubMed  CAS  Google Scholar 

  10. Molloy DW, Standish TI. A guide to the standardized Mini-Mental State Examination. Int Psychogeriatr. 1997;9:87–94.

    Article  PubMed  Google Scholar 

  11. Güngen C, Ertan T, Eker E, Yaşar R, Engin F. Standardize Mini Mental Test’in Türk toplumunda hafif demans tanısında geçerlik ve güvenilirliği. Türk Psikiyatri Dergisi. 2002;13:273–81.

    PubMed  Google Scholar 

  12. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–71.

    Article  PubMed  CAS  Google Scholar 

  13. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213.

    Article  PubMed  CAS  Google Scholar 

  14. Agargün MY, Kara H, Anlar O. Pittsburgh Uyku Kalitesi indeksinin Geçerliği ve Güvenirliği. Türk Psikiyatri Dergisi. 1996;7:107–15.

    Google Scholar 

  15. Rondanelli M, Solerte SB, Ferrari E. Electrolytes and cognitive function in the elderly: relationship between serum sodium and chloride concentrations and psychometric test scores. Panminerva Med. 1998;40:191–5.

    PubMed  CAS  Google Scholar 

  16. Fiocco AJ, Shatenstein B, Ferland G, Payette H, Belleville S, Kergoat MJ, Morais JA, Greenwood CE. Sodium intake and physical activity impact cognitive maintenance in older adults: the NuAge Study. Neurobiol Aging. 2012;33:829.e21–8.

    Google Scholar 

  17. Henry JP. Stress, salt and hypertension. Soc Sci Med. 1998;26:293–302.

    Article  Google Scholar 

  18. Oliver G, Wardle J. Perceived effects of stress on food choice. Physiol Behav. 1999;66:511–5.

    Article  PubMed  CAS  Google Scholar 

  19. Jovanovic H, Perski A, Berglund H, Savic I. Chronic stress is linked to 5-HT(1A) receptor changes and functional disintegration of the limbic networks. Neuroimage. 2011;55:1178–88.

    Article  PubMed  CAS  Google Scholar 

  20. Neily JB, Toto KH, Gardner EB, Rame JE, Yancy CW, Sheffield MA, Dries DL, Drazner MH. Potential contributing factors to noncompliance with dietary sodium restriction in patients with heart failure. Am Heart J. 2002;143:29–33.

    Article  PubMed  CAS  Google Scholar 

  21. Weinberger MH. More on the sodium saga. Hypertension. 2004;44:609–11.

    Article  PubMed  CAS  Google Scholar 

  22. Jin Y, Kuznetsova T, Maillard M, Richart T, Thijs L, Bochud M, Herregods MC, Burnier M, Fagard R, Staessen JA. Independent relations of left ventricular structure with the 24-hour urinary excretion of sodium and aldosterone. Hypertension. 2009;54:489–95.

    Article  PubMed  CAS  Google Scholar 

  23. Kawamura M, Kimura Y, Takahashi K, Satoh N, Oku K, Adachi T, Nakajima J, Murooka M, Fujiwara T, Hiramori K. Relation of urinary sodium excretion to blood pressure, glucose metabolism, and lipid metabolism in residents of an area of Japan with high sodium intake. Hypertens Res. 1997;20:287–93.

    Article  PubMed  CAS  Google Scholar 

  24. Iseki K, Iseki C, Itoh K, Uezono K, Sanefuji M, Ikemiya Y, Fukiyama K, Kawasaki T. Urinary excretion of sodium and potassium in a screened cohort in Okinawa, Japan. Hypertens Res. 2002;25:731–6.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

No sources of funding were used to assist in the preparation of this article. The author has no conflicts of interest that are directly relevant to the content of this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Baris Afsar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Afsar, B. The Relationship Between Cognitive Function, Depressive Behaviour and Sleep Quality with 24-h Urinary Sodium Excretion in Patients with Essential Hypertension. High Blood Press Cardiovasc Prev 20, 19–24 (2013). https://doi.org/10.1007/s40292-013-0002-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40292-013-0002-7

Keywords

Navigation